Vertebral Compression Fracture (VCF) After Spine Stereotactic Body Radiation Therapy (SBRT): Analysis of Predictive Factors

Tumor extravasation following a cement augmentation procedure for vertebral compression fracture in metastatic spinal disease

“…4,5,19,20 Although radiation treatment provides pain relief in general, it is not effective in palliating mechanical pain related to spinal instability or fracture. Rather than subjecting patients with advanced cancer to a major open surgery, procedures like BKP have evolved as an attractive minimally invasive solution to provide both spinal stability and mechanical pain palliation.…”

“…4,5,[19][20][21] In the treatment of VCFs, surgical management has shifted from open invasive surgery that can put the patient at moderately high risk of developing complications 2 to minimally invasive percutaneous procedures. 3,9,10,15 This change in practice has been driven largely by the intent of providing pain relief and vertebral stability while minimizing the interruption in patients' overall oncological care.…”

Editorial: Radiation-induced fracture

“…This complication is emerging with high crude risks ranging from 11% to 39%. 1,2,4 The dilemma lies in the SRS-induced VCF as to whether the cause is disease progression or simply loss of the mechanical integrity of the vertebral segment with the tumor still locally controlled. Our report describes for the first time the potential for osteoradionecrosis in the differential diagnosis of SRS-induced VCF.…”

“…4,5,7,8 In addition to the potential for bone and spinal cord damage from SRS, there is also the risk of vertebral compression fracture (VCF), estimated to be 11%-39%. [1][2][3]6 Patients who received the highest biologically effective dose (20-24 Gy in one setting) were at greatest risk for developing VCF, 3 and the etiology was hypothesized to be due to radiation-induced effects within the tumor and bone that caused structural weakening of the vertebral body. Open surgery, further radiation therapy, or chemotherapy would then be options for the treatment of this clinical problem.…”

Cement Salvage of Instrumentation-Associated Vertebral Fractures

“…Prior spine radiation results in increased risk of vertebral compression fractures. [1][2][3] Failure of fixation may require interruption or delay of systemic or radiation therapy, increasing the risk of local or systemic tumor progression. Vertebral compression fractures either within or adjacent to the surgical construct often result in either recurrent or progressive back pain.…”